Baikal skullcap (Scutellaria baicalensis) is a perennial herb native to southern China and throughout Korea. Scutellaria baicalensis is one of approximately 350 Scutellaria species.

Scutellaria baicalensis root is widely used in China as an adjuvant to chemotherapy for lung cancer. It is also commonly used in herbal medicine in Japan. Early studies have found that Scutellaria baicalensis may have anticancer properties. However, there is little clinical evidence. In Western herbalism, Baikal skullcap is also known as an ingredient in PC-SPES, used for prostate cancer.

Traditional uses include antibacterial, anticancer antifungal, anti-inflammatory, antiviral, and neuroprotective. Strong supportive evidence for Scutellaria baicalensis for any use is lacking at this time.

Warning: Scutellaria baicalensis is an ingredient in PC-SPES, which has been recalled from the U.S. market due to possible contamination; PC-SPES should not be used.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Traditional uses of Baikal skullcap include pain and inflammation. Preliminary research suggests no effect from a product for arthritis containing Baikal skullcap. Further research is required.

C

Traditional uses of Baikal skullcap include brain protection. Preliminary research suggests no effect from a product for minimal brain dysfunction containing Baikal skullcap. Additional research is needed before a conclusion can be drawn.

C

Traditional uses of Baikal skullcap include cancer treatment. It is a common ingredient in traditional Chinese medicine products. Preliminary research suggests some immunological changes with use in cancer patients. Further research is required.

C

Traditional uses of Baikal skullcap include liver protection. Preliminary research suggests that some preliminary benefit was associated with a product containing Baikal skullcap with respect to hepatitis B. Additional research is needed before a conclusion can be drawn.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

For cancer (adjunct to chemotherapy), one tablet of Baikal skullcap extract (the amount of extract per tablet is unknown) has been taken by mouth three times daily, starting 5-6 days before chemotherapy and every day thereafter.

Children (under 18 years old)

There is no proven safe or effective dose for Baikal skullcap in children.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid with known allergy or hypersensitivity to Baikal skullcap (Scutellaria baicalensis), its constituents, or members of the Lamiaceae family.

Side Effects and Warnings

Baikal skullcap may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Baikal skullcap may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs (such as metformin), herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Baikal skullcap may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased or decreased in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Use cautiously in patients using central nervous system (CNS) depressants. Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.

Use cautiously in patients taking rosuvastatin (Crestor®), according to pharmacokinetic research that baicalin, a constituent of Baikal skullcap, can decrease concentrations of rosuvastatin, likely by promoting the transportation of rosuvastatin into the liver.

Use cautiously in patients with autoimmune disorders or those receiving immunosuppressants, as Baikal skullcap and its constituents may have effects on the immune system.

Avoid in patients who are pregnant or breastfeeding, as Scutellaria baicalensis has the potential to cause maternal toxicity and uterine relaxation.

Avoid in patients with known allergy or hypersensitivity to Scutellaria baicalensis, its constituents, or members of the Lamiaceae family.

Baikal skullcap may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar, including metformin. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Baikal skullcap may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Baikal skullcap may interfere with the way the body processes certain drugs using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased in the blood and may cause increased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Baikal skullcap may increase the amount of drowsiness caused by some drugs. Examples include CNS depressants, benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

Because Baikal skullcap contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

Baikal skullcap may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Baikal skullcap may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Baikal skullcap may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

Baikal skullcap may increase the amount of drowsiness caused by some herbs or supplements.

Because Baikal skullcap contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.